Post-stroke self-management interventions: a systematic review of effectiveness and investigation of the inclusion of stroke survivors with aphasia

Purpose: To systematically review self-management interventions to determine their efficacy for people with stroke in relation to any health outcome and to establish whether stroke survivors with aphasia were included. Method: We searched MEDLINE, EMBASE, PsycINFO, CINAHL, The Cochrane Library, and IBSS and undertook gray literature searches. Randomized controlled trials were eligible if they included stroke survivors aged 18 + in a “self-management” intervention. Data were extracted by two independent researchers and included an assessment of methodological quality. Results: 24 studies were identified. 11 out of 24 reported statistically significant benefits in favor of self-management. However, there were significant limitations in terms of methodological quality, and meta-analyses (n= 8 studies) showed no statistically significant benefit of self-management upon global disability and stroke-specific quality of life at 3 months or ADL at 3 or 6 months follow-up. A review of inclusion and exclusion criteria showed 11 out of 24 (46%) studies reported total or partial exclusion of stroke survivors with aphasia. Four out of 24 (17%) reported the number of stroke survivors with aphasia included. In nine studies (38%) it was unclear whether stroke survivors with aphasia were included or excluded. Conclusions: Robust conclusions regarding the effectiveness of poststroke self-management approaches could not be drawn. Further trials are needed, these should clearly report the population included. •Implications for rehabilitation •There is a lack of evidence to demonstrate the effectiveness of self-management approaches for stroke survivors. •It is unclear whether self-management approaches are suitable for stroke survivors with aphasia, particularly those with moderate or severe aphasia. •Further research is needed to understand the optimal timing for self-management in the stroke pathway and the format in which self-management support should be offered

The impact of online platform transparency of information on consumer’s choices

Millions of Europeans use online platforms with almost blind trust that the platforms operate in the interests of the consumer. However, the presentation of search results, transparency about contractual parties and the publication of user reviews that contribute to the value of online platforms in Europe’s Single Digital Market also pose significant risks regarding consumer protection and market competition. The current study investigates how enhanced information transparency in online platforms might affect consumers’ trust in online activities and choice behaviour. Following an exploratory qualitative study, three online discrete choice experiments were conducted with representative samples of 1200 respondents in each of four countries - Germany, Poland, Spain and the UK. The objective of the experiments was to test whether increased transparency in the presentation of online search information, details of contractual entities and the implications for consumer protection, and user reviews and ratings would affect consumers’ choices. The results show that increased online transparency increases the probability of product selection. A comparison across the four countries found that the similarities in responses to online transparency were far greater than the differences. The findings are discussed in relation to biases and heuristics identified in behavioural science. In conclusion recommendations are made to increase online transparency which the empirical evidence of this study shows would benefit both users and platform operators

Effect of source type and protective message on the critical evaluation of news messages on Facebook: Randomized controlled trial in the Netherlands

Background: Disinformation has become an increasing societal concern, especially due to the speed that news is shared in the digital era. In particular, disinformation in the health care sector can lead to serious casualties, as the current COVID-19 crisis clearly shows. Objective: The main aim of this study was to experimentally examine the effects of information about the source and a protective warning message on users’ critical evaluation of news items, as well as the perception of accuracy of the news item. Methods: A 3 (unreliable vs reliable vs no identified source) × 2 (with protective message vs without) between-subject design was conducted among 307 participants (mean age 29 (SD 10.9] years). Results: The results showed a significant effect of source information on critical evaluation. In addition, including a protective message did not significantly affect critical evaluation. The results showed no interaction between type of source and protective message on critical evaluation. Conclusions: Based on these results, it is questionable whether including protective messages to improve critical evaluation is a way to move forward and improve critical evaluation of health-related news items, although effective methodologies to tackle the spread of disinformation are highly needed. Trial Registration: ClinicalTrials.gov NCT05030883; https://clinicaltrials.gov/ct2/show/NCT0503088

Study on the impact of marketing through social media, online games and mobile applications on children's behaviour

Item does not contain fulltextThe European Online Games, Social Media and Mobile Application sector has grown substantially in recent years and children are exposed to increasingly sophisticated marketing techniques online which are often outside the purview of existing regulatory frameworks. This study aims to provide a better understanding of online marketing to children and to inform effective policy measures for the protection of children as consumers. The study uses a range of information sources, including a systematic literature review, a review of legislation and regulatory framework at EU and Member State level, in-depth analysis of games, focus groups with parents and children, a survey with parents, and behavioural experiments on advergames and in-app purchases. The study finds that online marketing practices have an impact on children, and that children have difficulties recognizing marketing content, in activating defence mechanisms and in taking decisions. The analysis also shows that although parents play an important role in mediating their children’s online behaviour, parents are often not fully aware of the risks their children are exposed to in online environments. The study concludes with policy recommendations focussing on policies to address children as a particularly vulnerable consumer group.410 p